HomeMy WebLinkAbout20173553.tiffNORTH WELD COUNTY WATER DISTRICT
P.O. BOX 56
32825 CR 39
LUCERNE, CO 80646
PHONE: (970) 356-3020 FAX: (970) 395-0997 • E-MAIL: water@nwowd.org
Board of Directors: Charles AchzIger, Gene Stifle, Robert Ambrechl, Todd Been, Gary Simpson Menages Rick Pickard
ACCOUNT NUMBER
NAME AND SERVICE ADDRESS
BILLING PERIOD
MARY U. & MICHAEL J. WOODRUFF
55005
41640 CR 39
01/23/2017-02/21/2017
AULT, CO 80610
10
Water Class P (KGal)
70 % of 1.000 Acre Foot
228
Transferred Water
0
Allocation Adjustment
0
Less YTD Usage
17
Remaining Water Allocation
211
'
Plant Investment Class
70 % of 1.000 Acre Foot
228
Less YTD Usage
17
Remaining PI Allocation
211
Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb
Effective 1/1/17: Monthly Rate Change 0-6 Kgal419.20; Over 6 Kgal $3.20/Kgal: Non -Potable $1.10/Kgal
Prey. Read Curr, Read Usage Unit
Amount
Previous Balance
19.20
02/13/2017 Payment -
-19.20
02/21/2017 Standard - Full 77 81 4 kgal
19.20
Current Amount
19.20
Total Amount Due
19.20
Scanning Cover Sheet
for
Septic Permits
Permit #
Permit Type:
SE -0200028
Health 1 Residential I Statement of Existing
Situs Street Address 41640 CR 39
Situs City, State, Zip
SeclTownlRange: 05 -07N -65W
Parcel # (12 digits)
070905200038-R2160103
Owner Full Name: NOLL KENT I
Owner Address: 41640 WCR 39
AULT,CO 80610
Contact Name: NOLL KENT I
Contact Address: 41640 WCR 39
AULT,CO,80610
Application Status: RECORDED
Application Date: 04/0812002
Owner Phone #: 9708342271
Contact Phone# 9708342271
Information above has been Verified in Accela by em►alo ee noted be/ow
X
Processed by: Date
September 17, 2008
Report ID: EHS00024v003 Page 1 of 1
Print Date -Time: 9/17/2008 3:04:49PM
' WELD COUNTY DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT
1555 NORTH 17TH AVENUE
GREELEY, COLORADO 80631
PHONE (970) 304-6415 FAX (970) 304-6411
STATEMENT Off' EXISTING SEEEIC F MII
Permit #:
Owner:
Applicant:
Parcel #:
Location:
Legal Desc:
SE -0200028
NOLL KENT I
NOLL KENT 1
0709-05-0-00-024
41640 CR 39 05-07-65
13949S2NW45765E
Sec/Twn/Rng: 05 07 65 PERMIT
Applied: 04/08/2002
XC UPRR RES (1R)
Description: HOUSE
Commercial: N Residential: Y Acres: 80
# of Persons: 3 Basement Plumbing: N
# of Bedrooms: 3 Bathrooms - (Full): 1 (3/4): 0 (112): 0
Water Public: Y Water Source: NORTH WELD WATER
Water Private: N Cistern: N Well: N Well Permit Number: ??
Septic Tank: Int I n
Absorption Trench: UNK sq. ft.
Absorption Bed: (goon sq. ft.
Tank Material: CONCRETE
Year Installed: UNK
NOTICE
The property owner/agent has certified by Notary Seal that the above described septic system is in fact installed as described, and
exists at this time on the parcel identified above by the parcel number and/or legal description, and further states that the system
IS / IS NOT in good working order and to the best of his/her knowledge IS / IS NOT failing to function properly.
The property owner/agent further understands that any falsification or misrepresentation may result in the revocation of any permit
granted based upon this information hereby submitted and in legal action for perjury as provided by law.
The Statement of Existing Record relies on information the property owner or his/her representative provides, under oath, indicating
current status of the system and representing to the best of his/her knowledge that the system IS / IS NOT failing to function properly.
Issuance of the Statement of Existing Permit for any system does not constitute assumption that the site was evaluated or inspected
during any phase of construction by this Department to meet regulations.
Form: S EXIST
Environmental Health Specialist
Date
DATE
APR -O4 -200L THU 08:25 AN ENVIRON HEALTH SERVICES 9103046411 P. 02
WELD COUNTY DEPARTMENT OF PUBLIC SE # CG�d]2-S _____,
HEALTH AND ENVIRONMENT ORG PERMIT #
inns til. i71' AVENUE REPAIR #
GREELEY, COLORADO 80031 LOAN N
PHONE: (874) 3444410 ISM; # J -
FAX (0h) 304.$41I
STATEMENT OF EXISTING FOR SEPTIC SYSTEM
(PLEASE FILL OUT IN
PARCZ.# O-1O7O 5co o° Z +
PROPERTY 01V1tiiER. ,voc.
MAILING ADDRESS Vi yo 1.061 2.
PHONE No. I?7°1 $ 3'/- 22 7/
37 AiLT to. eeio
City Stain xIp
DESCRIPTION OF BiYILDING (ex, bonne, mobiielmodalar Lome, shop, offlee) OU.S
SITE."LOCA lid+1 ADDRESS r 0 to 3 y VL {J. 704/ b
S J1lWA, City State Zip
LEGAL DESCRIPTION PT PT_ SECTION 5 TOWNSlP ' 7 RANGE er-
SUBDI ISION
CENCUS TRACT. _ a3
COMMERCIAL YES
NUMBER OF PERSONS 3
BEDROOMS 3
WATER WPM PUbL]C
PRJvATE r . C'ISfRN S ! ti ■
LOT BLOCK,^ flLI1G
I.OT S1ZE/ACRES So A .QCS
RESIDENTIAL.
BASEMENT PLUMBING YES fi)
BATHROOMS FULL I - 3/4
UTILITY NAME N0RT# 4,16 10- caw r
WELL YES I1
tQAT '/z.
SYSTEM ST EM SUE! Septic tank material is constructed of coAq&rte and ba.I 11 Z c'17 -- gallons a pscity.
FIELD: Trench_ spare feet or Bed_ I 9Ofitz_L_ 3quaro fret YEAR INSTALLED
You are required to draw a diagram of the system clo tlye reverse side dab' tone tthusktiaffloy,and indicate
lucaiitin, length, width, and distance from the dwelling.
The undersigned property owner hereby cerbiler that the above described septic system le in feet inetaled, as
described, nod exists at this time en the parcel aground identified by the above Iege) description and further states
that the emLe ie good woridug order anti to the best of his/her imawiedge ifjyaflttg to fnaetdon
properly,
I further understand that any falsification or misrepresentation may molt in revocation of any permit granted basod
upon thin informatlotl herby aubmiitted In , n r1',, : rjury as provided by law.
-B-02
DATE
OWNER
Sub5eri' . and awe n to, forth kne this
by
•
Witness my band aid official seal
STATEMENT OF EXISTING REVIEWED BY
day of
y commis ' n rapines:
Poo a
199 ._.
AL EEALTR SPECIALIST
3
1k"��'
Go
on 09060,,,,T
c,,r
n
r
OOIrORADO
oa000ae
April 11, 2002
Kent Noll
41640 CR 39
Ault, CO 80610
RE: Kent Noll No: 02-034
Dear Mr Noll:
DEPARTMENT OF PUBLIC HEALTH & ENVIRONMENT
1555 N. 1
Grealey , CO 60631
Website: wwor.co.weld.r..us
Administration: (970) 304.6410
• -Fax (570) 304-6412
Public Health Education &Nursing: (970)304.6420
Fax (970) 304.6416
Environmental Heath Services: (970) 304=6415
Fax (970) 304-6411
On 04/10/2002 an evaluation of the existing individual septic disposal system at:
41640 CR 39, Ault; .
Section 05, Township 07, Range 65,
was conducted by Stephen J Wiatrowski, an Environmental Specialist of this department.
The existing individual septic disposal system is of sufficient size and capacity to adequately
handle the proposed load. This evaluation is based on a final treatment capacity fora 3
bedroom residence. ..
Be advised, neither the County of Weld nor any of its agents or employees undertake or
assume any liability to the owner of the above property, to any purchaser of the above property
or to any lending agency making a loan on the above property or in the report.
This inspection was conducted for the purpose of determining compliance with current
regulations and for detecting health hazards observable at the time of inspection. This does not
constitute a warranty that the system is without flaw or that it will continue to function in the
future. Inspections requested during periods of snow cover and high soil saturation may be of
questionable value to potential buyers due to adverse conditions. Evaluations based on
Statements of Existing (S.O.E.) relies on information the property owner provides, under oath,
indicating current status of the system and representing to the best of his/her knowledge the
system is not failing to function properly.
IP We can be of any further assistance, please contact our office at (970) 304-6415.
Sincerely.
coraicgir, ')__I__
Stephen J Wiatrowsld
Environmental Health Specialist
5orsamss73Appvd
1
.WATER SUPPLY: C1 -4 t I
O *IR
tee
INDIVIDUAL SEWAGE DISPOSAL REQUEST . No:': (5(19-
• c7 t
SYSTEM EVALUATION • RECORDEDEXEMPTION NO..:
. DATE RECEIVED: 1 �._{�2.
f{�
C..�.1� 1�1*;,.T1.! .•. 1 RECE�'tTED Y: '�(' ��
FEE $�! t DATE INSPECTED: L DLL I() -C _
OWNER: Kl/ I I k€i"k ' p z .ei()- 8c3(i - 22-2 1
NAILING ADDRESS•: l ( 6 (-0 c e 3el_____ ` .'- 610
STATE ZIP
SITE ADDRESS= 4-( ( J- CITY
CITY i. . STATE ZIP .
LEGAL DESCRIPTION: PT: PT : • ' . 'SEC: 'TWN: 4_ N. RNG: el L W
SUBDIVISION:- • , - - - _ _- -LOT: •
SIDENTI i+/COMMERCIAL
x,R a FLO:
TOTAL ACRES:
PERMIT ON RECORD:, name: ,4 Y .6=0;poir Permit No:: -tns: 0.E
NO
Sys tean• Size: . Tank: 1 50 gal lone Trench e'- , .- square feet- Red: I1$'4 square feet
Percolation Rates
Engineer Des-ign:' YE
Percent 'Ground( Slope: ---'
Direction.`
The septic- system identified above aV-of sufficient cite•to, aecommodete-the prop0ae_d
alterations(*) indicate'dd below to. the' 'structure(i) served by' this, ayatem. Il,pz
•.
-• PROPOSED: TOTAL
Description
P errone: . . -
Redrogmet - • 3. -
.Sathroams:
. Basement'Plumbing: yt
e axis n- septic- sys RE.■IRED RE
ao oamn ate t propos.•,altera.'one to e struct
X►DDITIONS
ED to ha
the to
erved;
ons made to
Neither the County of Weld•nor any of, its agents or employees undertake or assume any liability to
the owner of the above property, 'to any purchaser;• o€- the above .property •or teeny lending agency
making, a loan on. the above. property or'in the report:- -
This inspection was conducted for the purpose -of determining'com:pliance with current regulations
and for detecting heawlthhazards'obeex-vnble $t -the time of inspection.' This doss not constitute
a warranty. •that. the ayetem is without flaw or that it will continue. to .functionAa the future.
Inspections requested during periods of snow cover and high soil saturation may be of questionrib1e•
value to.potentiai buyers due to -adverse conditions: evaluations based en Statetents of Existing.
(S.O.E.) relies on information the property -owner provides, under oath, indicating current status
of -the 'eaystem and repreeentinig to _the bent .of hie/her knowledge the system is not' failing to
function properly. • - . : - . - .. ' ' '
Hello